Monday 29 July 2013

Why labour hurts 4

Imagine you are still a cave woman who is just so fed up with life in a damp mouldy old cave. So along with your hunky cave man you decide to go live on the hill. You look forward to waking up to a stunning view bathed in untainted primordial sunlight. Bliss.
However, there is one factor you forgot to consider. A hill. You will have to carry all your building materials up the hill to build your hut. Gravity will not be your friend. However, if you decide to build in the valley and forgo the stunning view, it will be easier to get materials down rather than up.
So working WITH gravity is easier, mmmmm.
If we lie down in labour the hard working uterus has to work even harder cos it is working against gravity, pushing baby up hill. The contractions will have to become stronger and so become painful.
If we remain in an upright position, on a chair/birthing ball or leaning forward on a bean bag etc. then the contractions are working with gravity and do not have to increase in strength. Simple.
Then why oh why do women, as soon as you show them into the labour room, make straight for the bed and lie down. We have chairs. We have birthing balls. We even have a large scrunchy bean bag. We also have a beautiful birthing pool where you can sit or kneel in relaxing warm water and labour in comfort.
Once you are aware of why labour hurts you can face labour with fresh expectations. You can make a birth plan that includes staying upright and use of the pool to relax in. You can inform your midwife and birthing partners that you need a quiet atmosphere in order to do your chosen relaxation technique.
You can have a pain free labour.
You can do it.
I did it.
Twice, so I know it works.

Saturday 20 July 2013

Why labour hurts 3

Imagine you are a cave woman coming toward the end of your labour when a saber toothed tiger appears at the cave door. OMG. The first thing you would do is to release adrenalin into your system so that you have extra energy to run away or stay and fight. But 'Oh No' your cervix is nearly fully dilated, if your baby is born now then the tiger will think its her birthday and celebrate with a very fresh human, covered in a tasty liquour dressing accompanied by a side order of bloody placenta. Yum.
Mother nature however has other tricks up her sleeve and has put receptor or binding sites on the cervix for adrenalin. The adrenalin secreted when we are under physical or mental stress 'sticks' to the cervix and helps to stop it from opening. Your cave baby is thus held in utero untill you can run out of the back cave door leaving your cave buddies to scare off the tiger. Sorted. Or is it?
Unfortunately mother nature has not moved with the times. Curse you evolution. In the modern world we no longer need adrenalin receptor sites on our cervix and they have become a hindrance. Todays modern woman is so afraid of going into labour that as soon as she does the adrenalin produced from the mental stress will attach itself to the cervix and hinder dilatation. The contractions will have to become stronger in order to heave the resisting cervix up and so become painful.
Howells et al (2000) was a piece of research which compared injecting the uterine cervix before surgery with adrenalin or another substance. The adrenalin worked best at reducing blood loss as it caused the cervix to become rigid. This is similar to how adrenalin performs during labour when levels are high enough to affect the cervix.
A relaxed person does not secrete adrenalin. Relaxation techniques previously discussed in this blog can be used in pregnancy and labour to prevent the cervix being restricted in its dilatation. This should make the labour shorter and easier and end all the cries of " What do you mean I'm not in labour? I've been contracting for 2 f***ing days and my cervix has still not dilated?" Oh bliss.

Monday 1 July 2013

Why labour hurts 2

Imagine you are Buffy the vampire slayer walking through an eerie graveyard at the dead of night when suddenly, out leaps a vicious vamp looking for your blood. What is your reaction?
The first thing your body would do is to send an automated message to your adrenal glands to release adrenalin. This adrenalin would then circulate the body and make certain changes in order to maximise your chances of survival.
One of the ways it does this is to redirect blood flow from the body to the arms and legs so that you can run away very fast from the vampire or, if you really are Buffy, you can stay and fight.
Women today are scared of going into labour cos they believe they will be in agony for hours and hours, as soon as they have a few contractions the anxiety they feel starts releasing adrenalin from the adrenal glands. As with Buffy, this adrenalin sends extra blood to the arms and legs. This means that non vital organs within the body, such as the uterus, get starved of oxygen rich blood.
When a labouring uterus gets starved of oxygen it produces lactic acid, this then connects to pain receptors and sends messages to the brain of PAIN!
Running too soon after a meal has the same effect on the digestive system. The adrenalin released in response to physical exercise starves the gut of oxygen and you get a stitch. All you need do under these circumstances is to stop exercising and the stitch will go away. Unfortunately we do not have this option when going into labour.
Learning how to relax during the pregnancy so that you are ready when the big day comes  is vital for a pain free labour. A relaxed body does not secrete adrenalin so the blood flow is not sent away from the body to the arms and legs. During a normal labour with a normally presenting baby there is no reason for the contractions to hurt.
Choose a  method of relaxation that suits you best, stay upright on a comfy chair or other upright position and you will be amazed, as I was when I experienced my first pain free labour.